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Does Blockchain help with semantic interoperability?

Blockchain in healthcare

Blockchain has been the buzz of healthcare IT lately, maybe even surpassing the status of FHIR. Momentum picked up for blockchain last year as the ONC announced a blockchain research challenge and announced [1] the winners in August 2016. So what exactly is blockchain?

Blockchain is a technology that keeps a permanent record of online transactions or exchanges. It was the foundation for trading the digital currency bitcoin, and has been around since 2009.

The permanent record can be shared among a network of computers. The records themselves are distributed among the network, rather than being stored locally. The name blockchain itself can be derived from the fact that (1) each transaction can be thought of as a block, and (2) a ledger of the transactions can be thought of as the chain.

There are many hopes and dreams of what blockchain can accomplish for health data interoperability. Some that are mentioned most often include:

The first two advantages involve moving data while keeping track of its source. Blockchain definitely seems to have unique features to solve healthcare IT challenges in this area. However, the last advantage deals not only with moving and tracking data, but in merging it together with unambiguous and shared meaning, often referred to semantic interoperability.

The merging of data brings to the surface additional questions. How will the payload be encoded in blockchain? Does healthcare still continue to use HL7 [3] V2, CDA [4], or even FHIR [5] encoding? And, if so, how do we eliminate the mapping and vocabulary challenges that are so prevalent with traditional types of coding? I haven’t seen a good answer to this.

The ability to efficiently move lots of data around while maintaining patient identity would be a great lift to the healthcare IT industry. I hope blockchain can deliver on these challenges. But once the data gets where it is going, the challenge might still remain with piecing the data all together. HL7 FHIR [6] might help in this area with more consistent data records called resources, and just maybe the two big buzzwords of healthcare might be the ultimate solution together.